CQC report explained · a residential care home
What the CQC found at Clough House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Inspectors found improvements in risk assessments, infection control, medicines, incident recording, recruitment and staffing, although not all bedrooms had accessible call bells.
- Effective?
- Good
- Care was planned around people's needs and choices. Staff supported people with food, health conditions and access to healthcare, but monitoring of legal authorisations for restrictions needed to be more consistent.
- Caring?
- Good
- People said staff were kind, caring and respectful. Inspectors saw person-centred care and improvements in people's privacy, dignity, independence and choice.
- Responsive?
- Requires improvement
- This key question was not inspected during this focused visit. The report says no areas of concern were identified in the other key questions, so they were not inspected.
- Well-led?
- Good
- Management, quality checks and the culture of the home had improved significantly. The report says the previous breaches and associated shortfalls had been addressed, but DoLS monitoring still needed to become fully embedded.
What inspectors found, June 2022
Rated Good; inspectors found safe, kind care and major improvements, but some DoLS authorisations and bedroom call bells needed action.
This was an unannounced focused inspection on 18 May 2022. One inspector spoke with nine people, four staff and reviewed care, medicines, incident, recruitment and management records. They also looked around the home and observed staff interactions.
The home was rated Good overall, with Good ratings for Safe, Effective, Caring and Well-led. People said they felt safe, respected and cared for. Inspectors found improvements in medicines, infection control, staffing, care planning, food choices, the environment and management.
There were two issues needing attention during the visit. Some people who needed legal authorisation for restrictions did not have this in place, although immediate action was taken. Not all bedrooms had accessible call bells, and the home also acted immediately on this.
People felt safe
People told inspectors they felt protected from abuse and avoidable harm. Staff understood how to recognise and report concerns.
“People told us they felt safe and protected from the risk of abuse and avoidable harm by staff who understood how to recognise, respond and report concerns.” from the report
Medicines were better managed
Medicines records and storage had improved. Staff training and regular checks had helped reduce medicine errors.
“Medicines administration systems were robust and well organised.” from the report
Kind and respectful care
People described staff as caring and respectful. Inspectors observed positive interactions and support for people's dignity and independence.
“People told us they were treated with dignity and respect by staff.” from the report
Strong improvement in leadership
The provider had made major changes to management checks, staffing and the culture of the home. Staff morale and people's experiences had improved.
“The provider had made significant improvements to the quality monitoring, governance and leadership arrangements at the home.” from the report
Some legal authorisations were missing
needs fixingSome people's care involved restrictions that required legal authorisation, but the authorisations were not in place at the time inspectors checked. Immediate action was taken, and the report recommended better monitoring as people's needs change.
“We found people whose care required authorisations who did not have these in place.” from the report
Call bells were not accessible in every bedroom
needs fixingInspectors found that not all bedrooms had accessible call bells. The provider took immediate action to address this.
“We however noted that not all bedrooms had accessible call bells.” from the report
- 01How do you check that every person who needs a DoLS authorisation has one in place?
- 02How often do you review DoLS needs when a person's condition or care restrictions change?
- 03Have all bedrooms now been fitted with accessible call bells, and how do you test them?
- 04How are the improvements in medicines management and incident recording checked and kept in place?
- 05What support and training do staff receive for the needs of people living with dementia or mental health needs?
This was a focused inspection of Safe, Effective, Caring and Well-led; other key questions were not inspected and their previous ratings were used when calculating the overall rating. This explanation was written from the published report of 18 June 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, June 2019
Rated Requires Improvement; inspectors found serious shortfalls in safety, consent, choice, nutrition and management.
This was an unannounced inspection on 17 and 25 April 2019. Inspectors reviewed records, spoke with people living at the home, a family member, staff and outside professionals. They also checked care files, staff files, medicines, training and safety records.
People generally said they felt safe, and staff usually responded in a reasonable time. Care plans were detailed and regularly reviewed. Staff had a wide range of training, and people gave some positive feedback about activities and the food.
However, the home did not always protect people from harm or respect their choices. Recruitment checks were incomplete, medical help was not always sought quickly, infection control was poor, and some medicines were not stored safely. People had been restricted in daily life, including being refused pudding unless they ate their main meal.
The overall rating and all five question ratings were Requires Improvement. This is worse than the previous Good rating, published on 21 December 2016. The provider was asked to produce an action plan, and CQC said it would monitor progress and return to inspect again.
Detailed care planning
Care plans recorded people’s likes, dislikes and needs. They were reviewed regularly and kept up to date.
“The care plans were informative and these were supported by a summary, which provided staff with a good overview of individual needs.” from the report
Staff training and induction
New staff received a varied induction. Staff had completed a broad range of training and were regularly supervised.
“Staff training records showed a wide range of learning modules had been completed, which helped to ensure the staff team were kept up to date” from the report
Activities and outside support
People were generally satisfied with the activities. Community professionals gave positive feedback about the support provided.
“An activity co-ordinator was employed four mornings each week. People said they were satisfied with the activities provided.” from the report
Some positive relationships
Some people said staff were kind and patient. People also said they felt safe living at the home.
“Everyone said they felt safe living at Clough House.” from the report
Unsafe recruitment
seriousPolice checks had not always been completed before staff started work. There was also no evidence of regular repeat checks.
“Police checks had not always been conducted before people were employed.” from the report
Risks and medical concerns
seriousRisk assessments were not always effective. Medical advice was not always sought promptly when two people needed urgent attention.
“Where concerns had been identified for two people requiring urgent medical attention, staff had not acted on these in a timely manner.” from the report
Poor infection control
seriousInspectors found problems with isolation, soiled linen, protective equipment and cleaning. Some areas needed a deep clean.
“People were not protected from the risks of infection. Effective infection control practices were not followed.” from the report
Consent and restrictions
seriousOne person was restricted from leaving without the correct legal process. The home also imposed restrictions on daily choices, including food and access to rooms or communal areas.
“The provider had failed to ensure consent had been properly obtained in line with the Mental Capacity Act 2005.” from the report
Nutrition and choice
seriousPeople could be refused pudding unless they ate their main course. Meal times were not flexible, and inspectors found that one person had significant weight loss.
“This was unacceptable practice, as it supported institutional practices and did not promote independence or choice.” from the report
Weak management checks
seriousInternal audits often reported 100% compliance even where inspectors found significant problems. This meant leaders did not have a reliable picture of safety and quality.
“The provider had failed to ensure systems had been introduced which effectively assessed and monitored the quality of service provided.” from the report
- 01Have all staff now completed the required police and other recruitment checks before starting work, and are repeat checks recorded?
- 02How do you now make sure risks are assessed, urgent medical advice is sought promptly and accident records show the action taken?
- 03How do you prevent infection, including deep cleaning, handling soiled linen and using protective equipment?
- 04How do you make sure people can make daily choices about meals, personal care, leaving the home and using communal rooms?
- 05What action has been taken to meet the four breached regulations, and how do you check that the changes are working?
This was an unannounced inspection of the care home covering all five CQC questions; all five ratings were Requires Improvement and the previous overall rating was Good. This explanation was written from the published report of 8 June 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Clough House
3 rated inspections over 5 years: the service has held its Good rating throughout.
- June 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementWell-led: Requires improvement
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- April 2012
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 23 November 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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85 live-in carers within about an hour of Lancashire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 78 can care for a couple. 11 years' experience on average.
“She understands the needs of an elderly person in the early stages of dementia and has treated my mother with great kindness and skill.”
“Thanks to Tracy, Dad was always immaculately dressed and clean, his meals were all home cooked and nutritionally well balanced and his home was always kept really clean and tidy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.